Thursday, June 14, 2018

Why the healthcare sector still uses fax machines

We were just talking about how strange it is that the healthcare industry - doctors, clinics, pharmacies, hospitals - still use faxes when, who'd have thought it, an article appeared in the Globe and Mail on that very subject.
I have a healthy (sic) respect for the Globe's health correspondent, André Picard, who is usually well-informed, nuanced and generally spot on. In much of this article, though, he seemed to be flying by the seat of his pants and is ultimately unconvincing.
Picard argues that the health sector's use of faxes is an embarrassing anachronism and should be curtailed forthwith. That has usually been my general view too, but his arguments did not seem to stack up, and now I am second-guessing my own opinions on the matter.
Mr. Picard argues that healthcare's obsession with privacy "trumps convenience and even common sense", but I actually think that faxes probably are more secure and less hackable. Every year there are more and more email and web server hacks, but as far as I know faxes are not hackable. He goes further, with unwarranted condescension and chutzpah: "The notion that paper-based records are somehow safer and more secure than electronic records beggars belief. Yet, rules and regulations still hold that a fax is a secure means of communication while email is not considered secure." Well, it doesn't beggar my belief, and until Mr. Picard provides me with some evidence to show that email is more secure than faxes, then I think that the "rules and regulations" probably have it right.
He further argues that, at least according to one study he found, one in five faxed requests to medical specialists do not receive responses, although it seems to me that there is no necessary link between that statistic and the use of faxes (correlation does not imply causation, Mr. Picard - as a scientist you should have that at the forefront of your thoughts). And why would he suppose that using email would miraculously fix this problem? I don't have statistics to back it up, but certainly anecdotal evidence suggests that most people are so overburdened with emails that a good proportion of them are overlooked, even supposing that they make it through the spam filtering process.
Picard further confuses the issue (deliberately, I thought, just to support his point) by adding that studies have shown "time and time again" that half of medical errors are the result of communication problems. This may also be true, but "communication" here does not just relate to the use of faxes, but to medical communications of all kinds. Let's not conflate different things.
I thought the whole article was uncharacteristically sloppy and unscientific. I am not on commission from Brother or Canon (or whoever it is that still makes fax machines), but in fact there are compelling reasons why fax machines are still so widely used in the healthcare industry, as well as in other businesses. Email may be easier and quicker in some ways, but this is not just a case of an old dinosaur industry stuck in the past and moving too slowly. Indeed, it turns out that faxing is on the increase, not decrease. Remember what people said about vinyl records when the CD was invented? And now look at the music industry.

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